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Jeong H, Lee W, Jang SG, Pyo J, Choi EY, Baek SJ, Ock M. Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea. Curr Med Res Opin 2024:1-9. [PMID: 38646669 DOI: 10.1080/03007995.2024.2346334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND To ensure effective patient engagement, patients' efforts, partnerships with healthcare professionals, and the organisation's role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals' perception of patient engagement and compared the findings with that determined for the public in a previous study. METHODS An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher's exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study. RESULTS The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 86% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals' hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as "medical dispute mediation and arbitration programs", "fall prevention", and "infection prevention", there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses' perception being particularly more positive than that of physicians. CONCLUSIONS The healthcare professionals' perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public's perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.
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Affiliation(s)
- Hyeran Jeong
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | | | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Seung Ju Baek
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Lui JNM, Andres EB, Johnston JM. How do organizational culture and leadership style affect nurse presenteeism and productivity?: A cross sectional study of Hong Kong acute public hospitals. Int J Nurs Stud 2024; 152:104675. [PMID: 38277926 DOI: 10.1016/j.ijnurstu.2023.104675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Presenteeism is defined as a type of work behavior in which employees are physically present at work when ill, often with reduced performance. While organizational culture and leadership style are known to impact the organizational behavior of hospital staff, as indicated by increased burnout and decreased work engagement, their impact on nurse presenteeism and productivity has not been explored. Moreover, nursing studies often neglect the importance of using multi-level analysis, adopting aggregated unit-level scores to account for collective perceptions to evaluate culture and leadership. OBJECTIVE This study aims to evaluate the impact of unit-level organizational culture and leadership style on individual-level nurse presenteeism and productivity in acute care hospitals using multilevel analysis. DESIGN Cross-sectional study. SETTING(S) Three major acute care public hospitals in Hong Kong, where public hospitals provide over 90 % of inpatient services. PARTICIPANTS All full-time nurses (N = 4657) in the three study hospitals were invited to participate in this study. A total of 2339 nurses responded to the survey for a 65 % response rate. METHODS Organizational culture and leadership style are characterized using the competing values framework and a two-factor leadership style typology, respectively. Multilevel hierarchical linear modeling was applied with unit-level clustering in each hospital. RESULTS Hierarchical culture was the dominant culture (M = 3.64, SD = 0.74) in our nurse sample. None of the unit-level organizational culture and leadership styles were associated with nurse presenteeism, however, rational organizational culture at the unit-level was significantly associated with increased productivity (regression coefficient: 0.17, 95 % CI: 0.04-0.31). CONCLUSIONS This study provides hospital managers with improved understanding of the differential impact of unit-level organizational culture and leadership style on nurse presenteeism and productivity. Unit-level leadership style did not have a direct impact on nurse presenteeism and productivity in this study, while the externally focused rational organizational culture increased nurse productivity. Further research is needed to understand the impacts of modifiable work factors and nurse psychosocial emotions on presenteeism and productivity.
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Affiliation(s)
- Juliana Nga Man Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
| | | | - Janice Mary Johnston
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
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Moldovan F, Moldovan L. Fair Healthcare Practices in Orthopedics Assessed with a New Framework. Healthcare (Basel) 2023; 11:2753. [PMID: 37893827 PMCID: PMC10606008 DOI: 10.3390/healthcare11202753] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Background and Objectives: Healthcare systems are supported by the European ideology to develop their egalitarian concerns and to encourage the correct and fair behavior of medical staff. By integrating fair healthcare practices into sustainability, this requirement is addressed. In this research, our objective is to develop and validate, in the current activity of healthcare facilities, a new instrument for evaluating fair healthcare practices as a component of social responsibility integrated into sustainability. Materials and Methods: The research methods consist of deciding the domains of a new framework that integrates fair healthcare practices; the collection of the most recent fair healthcare practices reported by healthcare facilities around the world; elaboration of the contents and evaluation grids of the indicators; the integration of indicators related to fair healthcare practices in the matrix of the new framework for sustainable development; validation of the theoretical model at an orthopedic hospital. Results: The theoretical model of the new framework is composed of five domains: organizational management, provision of sustainable medical care services, economic, environmental, and social. The last domain is developed on the structure of the seven subdomains of the social responsibility standard ISO 26000. The seven indicators that describe fair healthcare practices are attitudes of the profession towards accreditation, effective intervention application, promoting a culture of patient safety, characteristics that affect the effectiveness of transfers, effective healthcare practices, feedback to medical staff, safety checklists. The new reference framework was implemented and validated in practice at an emergency hospital with an orthopedic profile. Conclusions: The practical implementation highlighted the usefulness of the new reference framework, its compatibility, and the possibility of integration with the reference frameworks for the evaluation of European hospitals, with the national legislation for the accreditation of hospitals and outpatient units, as well as with the ISO 9001 standard regarding the implementation of quality management systems. Its added value consists in promoting sustainable development by orienting staff, patients, and interested parties towards sustainability.
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Affiliation(s)
- Flaviu Moldovan
- Orthopedics—Traumatology Department, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Liviu Moldovan
- Faculty of Engineering and Information Technology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania;
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Simplicio C, Dini AP. Content validation of an instrument for medical record audits. Rev Bras Enferm 2023; 76:e20220109. [PMID: 37820133 PMCID: PMC10561927 DOI: 10.1590/0034-7167-2022-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 03/10/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To build and validate the content of an instrument to conduct medical record audits; to conduct a pre-test. METHODS Methodological study conducted from May/2020 to May/2021 in three stages: 1) development of the instrument by bibliographic survey and benchmarking; 2) content validation using the Delphi technique; 3) application of the instrument and descriptive analysis in a sample of 200 medical records. RESULTS An instrument was constructed with 11 domains containing sub-items that characterize the quality of care. Two stages of the Delphi technique were necessary to reach a content validity index higher than 0.90. For each domain, a graduated scale with a numerical value from 1 to 4 points was attributed, reflecting the quality of its completion. The average time of application was 35 minutes per record. CONCLUSIONS The tool proved to be viable to support clinical audits to identify the level of excellence and reveal opportunities for improvement in care processes.
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Affiliation(s)
- Carla Simplicio
- Universidade Estadual de Campinas. Campinas, São Paulo, Brazil
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Sin CMH, Huynh C, Maidment ID. Physicians' and nurses' perceptions of the factors influencing the implementation of paediatric clinical pharmacy services in Hong Kong: a qualitative study. Eur J Hosp Pharm 2023:ejhpharm-2023-003796. [PMID: 37541776 DOI: 10.1136/ejhpharm-2023-003796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVES To identify barriers and facilitators that influence the implementation of paediatric clinical pharmacy services in Hong Kong public hospitals from physicians' and nurses' perspectives. METHODS A qualitative study was conducted based on semistructured interviews of physicians and nurses who worked in the field of paediatrics in four public hospitals in Hong Kong. Interviews were held via telephone conversations using spoken Cantonese which were audio recorded, then translated and transcribed directly into English by the research team. Thematic analysis was used for data analysis and reflexivity was engaged through member checking, making field notes and reporting using the Consolidated Criteria for Reporting Qualitative Studies checklist. RESULTS A total of six barriers and five facilitators were identified from interviewing 17 participants, which included 7 physicians and 10 nurses. The barriers identified were the public's lack of understanding and recognition of clinical pharmacists, a culture of medical dominance, lack of resources and heavy workload, the need for a more transparent and defined role of clinical pharmacist at the institutional level, lack of proactive approach and involvement in direct patient care activities. The facilitators identified were the belief in the improvement of patient outcomes and the overall pharmaceutical service efficiency, trust and confidence in clinical pharmacy services, filling the clinical gap as a medicine information provider, and direct and coherent communication as a multidisciplinary team member. CONCLUSIONS Physicians and nurses reported that the implementation of paediatric clinical pharmacy services was adequate, but several key barriers were identified at both the external and internal levels.
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Affiliation(s)
- Conor Ming-Ho Sin
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
- Pharmacy Department, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
| | - Chi Huynh
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Ian D Maidment
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
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Hussein M, Pavlova M, Groot W. The Attitude of Hospital Directors Towards Normalising Accreditation Standards: A Qualitative Descriptive Study for Saudi Arabia. Int J Qual Health Care 2022; 34:6680108. [PMID: 36047710 PMCID: PMC9470101 DOI: 10.1093/intqhc/mzac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/12/2022] [Accepted: 08/31/2022] [Indexed: 12/05/2022] Open
Abstract
Background Accreditation is an important performance management tool. The engagement of stakeholders in pursuing accreditation plays a critical role in integrating standards into routine practice. Objective This study explores the attitude of hospital directors towards accreditation and investigates the mechanisms of normalising standards in Saudi Arabian hospitals. Methods Fifteen hospital directors across Saudi Arabia participated in semi-structured qualitative interviews. The interviews were conducted virtually, audiotaped, transcribed verbatim, and then analysed thematically using the NVivo-12 software package. The normalisation process theory (i.e. coherence, participation, actions and monitoring) was adopted to frame the study and describe the findings on normalising accreditation standards heuristically. Results Overall, the hospital directors perceived accreditation favourably, particularly by those with more experience or previous exposure to accreditation. This attitude was a factor in normalising standards into daily operations. The clarity of standards, availability of full-time quality professionals and alignment of accreditation standards with hospital strategies assisted hospital directors in making sense of accreditation (coherence) and moving towards engaging hospital teams in the process (cognitive participation). This motivation-driven engagement catalysed the initiation of purposeful operational activities to integrate standards in operations (collective actions). The integration included distributing standard sets to relevant owners, conducting gap analysis, constructing a corrective plan and prioritising tasks within timeframes. Despite the financial and structural constraints experienced, the integration resulted in enhanced organisational safety culture, team spirit, communication, public trust, reporting of safety concerns and standardising of procedures. Following the integration, the objective appraisal of accreditation benefits (reflexive monitoring) was critical in addressing what went wrong, what worked well, and subsequently in sustaining performance gains. Conclusion The effectiveness of integrating accreditation standards heavily relies on making sense of accreditation and understanding the mechanisms through which standards are routinised into operations. This study, using normalisation process theory constructs, indicates that standards integration phases are sequential, interlinked and influenced by culture, teamwork and leadership engagement. The findings helped in clarifying the accreditation operating process which may provide advantages to policymakers and stakeholders in making informed decisions on the implementation of accreditation.
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Affiliation(s)
- Mohammed Hussein
- Address reprint requests to: Mohammed Hussein, Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Randwyck, Maastricht, The Netherlands. Tel: +31 433885655; E-mail:
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht 6200 MD, The Netherlands
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht 6200 MD, The Netherlands
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Bord S, Sass I, Hayms G, Moskowitz K, Baruch H, Basis F. Involvement and skepticism towards the JCI Accreditation process among hospital's four sectors employees: suggestions for cultural change. Isr J Health Policy Res 2021; 10:74. [PMID: 34906237 PMCID: PMC8670208 DOI: 10.1186/s13584-021-00507-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementing the JCI Accreditation process as an organizational culture may face resistance. However, the skepticism and involvement of different hospital sectors (medical, nursing, paramedical, and administrative/logistic) in the process may vary. Conducting organizational change needs tools to decrease resistance. OBJECTIVES To investigate the attitudes, cultural norms, and satisfaction of the different sectors regarding the accreditation process, and to suggest ways to integrate the process as part of the organizational culture. MATERIALS AND METHODS A cross-sectional survey was conducted among 462 respondents (187 nurses, 95 physicians, 92 administrative, 88 paramedical) at Rambam Health Care Campus, a tertiary hospital in Israel. The hospital employees' attitudes, cultural norms, and satisfaction were assessed. ANOVA tests were used to examine the differences among the different sectors. The association between the satisfaction from the process and the preferred type of training was examined using Pearson's correlation coefficient. RESULTS Significant differences were found among the sectors in the scores related to attitude, cultural norms, and satisfaction from the accreditation process (F (3, 456) = 17.95, p < 0.001, η2 = 0.10). Gabriel post-hoc test revealed significantly lower scores between the medical and paramedical sectors. A positive correlation was found between the degree of satisfaction with the process and the satisfaction with the training type. Frontal education and video demonstrations were rated significantly higher among all 10 training types. CONCLUSIONS More efforts should be made to increase involvement among physicians and paramedical teams in the accreditation process. Each sector leadership involvement is essential for their involvement too. Early involvement of the Israeli Medical Association in the process might have achieved better physicians' collaboration. Frontal education and video demonstrations may help decrease skepticism and increase positive attitudes.
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Affiliation(s)
- Shiran Bord
- Health Systems Management, The Max Stern Yezreel Valley College, Yezraeel Valley, Israel
| | - Inna Sass
- JCI Accreditation, Rambam Health Care Campus, Haifa, Israel
| | - Gila Hayms
- Nursing Sector, Rambam Health Care Campus, Haifa, Israel
| | - Kobi Moskowitz
- Hospital Administration, Rambam Health Care Campus, Haifa, Israel
| | - Hagar Baruch
- Nursing sector, Rambam Health Care Campus, Haifa, Israel
| | - Fuad Basis
- JCI Accreditation, Technion Faculty of Medicine, Rambam Health Care Campus, Haifa, Israel
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Rhoden DJ, Dezordi CCM, Husein RAMM, Barbosa DA, Treviso P, Colet CDF, Stumm EMF. Nurses' stress and resilience before and after evaluation for hospital accreditation. Rev Bras Enferm 2021; 75:e20201341. [PMID: 34852118 DOI: 10.1590/0034-7167-2020-1341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to analyze and compare levels of stress and resilience in nurses before and after the assessment for maintenance of the Hospital Accreditation Certification. METHODS quantitative, observational, and longitudinal research, with 53 nurses from a philanthropic hospital, in the Rio Grande do Sul. Data collected in two stages, March, and July 2019, before the assessment visit and 60 days after, using the Bianchi Stress Scale and Resilience Scale. Descriptive and analytical statistics were employed. RESULTS the majority of participants showed an average stress level before and after the evaluation. The highest stress scores were related to Domains E (coordination of unit activities) and C (activities related to personnel administration). In both moments of the study, the participants had medium and high resilience. CONCLUSIONS managing people, processes, and assistance are stressful activities in the Accreditation process and increase the nurses' stress levels.
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Affiliation(s)
- Deise Juliana Rhoden
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul. Ijuí, Rio Grande do Sul, Brazil
| | | | | | | | - Patrícia Treviso
- Universidade do Vale dos Sinos. São Leopoldo, Rio Grande do Sul, Brazil
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Hussein M, Pavlova M, Ghalwash M, Groot W. The impact of hospital accreditation on the quality of healthcare: a systematic literature review. BMC Health Serv Res 2021; 21:1057. [PMID: 34610823 PMCID: PMC8493726 DOI: 10.1186/s12913-021-07097-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation. METHODS We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes. RESULTS We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures. CONCLUSION There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.
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Affiliation(s)
- Mohammed Hussein
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Department of Hospitals Accreditation, Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Riyadh, Saudi Arabia.
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Mostafa Ghalwash
- Department of Hospitals Accreditation, Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Riyadh, Saudi Arabia
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands
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Rhoden DJ, Colet CDF, Stumm EMF. Association and correlation between stress, musculoskeletal pain and resilience in nurses before hospital accreditation maintenance assessment. Rev Lat Am Enfermagem 2021; 29:e3465. [PMID: 34468622 PMCID: PMC8432572 DOI: 10.1590/1518-8345.4658.3465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/05/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE to associate and correlate musculoskeletal pain, stress and resilience of nurses in the maintenance of Hospital Accreditation Certification. METHOD longitudinal study in two moments, before and after the Accreditation maintenance visit, March and June 2019, with 53 nurses from a hospital institution. The data collected was: sociodemographic, clinical and occupational variables, stress, osteomuscular pain and resilience. Descriptive variables, Chi-square test, t test, Fisher's exact test, Pearson's correlation and Spearman's correlation coefficient were used. RESULTS most of the study participants had average stress levels before and after the evaluation. Most of those who reported pain were at medium stress levels at both times. The resilience capacity increased after the evaluation, which demonstrates that the experienced stressors were adequately addressed. There was no significant association between the cortisol levels and the perceived stress. CONCLUSION occupational stress and musculoskeletal pain were experienced by nurses during the Accreditation processes. It was evident that individuality permeated the perception of stress and resilience allowed to overcome the tensions experienced. The study identified that there is a need for planning and implementation of actions to collaborate with the nurses in the best confrontation, aiming to promote resilience.
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Affiliation(s)
- Deise Juliana Rhoden
- Universidade do Noroeste do Estado do Rio Grande do Sul, Ijuí, RS,
Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
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Hovlid E, Braut GS, Hannisdal E, Walshe K, Bukve O, Flottorp S, Stensland P, Frich JC. Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis. BMJ Open 2020; 10:e038850. [PMID: 32868366 PMCID: PMC7462249 DOI: 10.1136/bmjopen-2020-038850] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES External inspections are widely used to improve the quality of care. The effects of inspections remain unclear and little is known about how they may work. We conducted a narrative synthesis of research literature to identify mediators of change in healthcare organisations subject to external inspections. METHODS We performed a literature search (1980-January 2020) to identify empirical studies addressing change in healthcare organisations subject to external inspection. Guided by the Consolidated Framework for Implementation Research, we performed a narrative synthesis to identify mediators of change. RESULTS We included 95 studies. Accreditation was the most frequent type of inspection (n=68), followed by statutory inspections (n=19), and external peer review (n=9). Our findings suggest that the regulatory context in which the inspections take place affect how they are acted on by those being inspected. The way inspections are conducted seem to be critical for how the inspection findings are perceived and followed up. Inspections can engage and involve staff, facilitate leader engagement, improve communication and enable the creation of new networks for reflection on clinical practice. Inspections can contribute to creating an awareness of the inspected organisation's current practice and performance gaps, and a commitment to change. Moreover, they can contribute to facilitating the planning and implementation of change, as well as self-evaluation and the use of data to evaluate performance. CONCLUSIONS External inspections can affect different mediators of organisational change. The way and to what extent they do depend on a range of factors related to the outer setting, the way inspections are conducted and how they are perceived and acted on by the inspected organisation. To improve the quality of care, the organisational change processes need to involve and impact the way care is delivered to the patients.
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Affiliation(s)
- Einar Hovlid
- Institute of Social Science, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Global Public Health and Primary Care, Universitetet i Bergen, Bergen, Norway
| | - Geir Sverre Braut
- Institute of Social Science, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Western Norway University of Applied Sciences, Haugesund, Norway
| | - Einar Hannisdal
- Department of health, County Governor in Oslo and Akershus, Oslo, Norway
| | - Kieran Walshe
- The University of Manchester Alliance Manchester Business School, University of Manchester, Manchester, UK
| | - Oddbjørn Bukve
- Institute of Social Science, Western Norway University of Applied Sciences, Sogndal, Norway
| | | | - Per Stensland
- Department of Global Public Health and Primary Care, Universitetet i Bergen, Bergen, Norway
| | - Jan C Frich
- Institute of Health and Society, Universitetet i Oslo, Oslo, Norway
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Gao T, Gurd B. Impact of a management innovation on professional subcultures – the case of a balanced scorecard implementation in a Chinese hospital. CHINESE MANAGEMENT STUDIES 2020. [DOI: 10.1108/cms-11-2019-0408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The balanced scorecard (BSC) has been a popular management innovation in health care. Implementing an innovation like the BSC can change the professional subcultures of a hospital. The purpose of this paper is to measure subcultures to establish the level of change during the implementation of a management innovation in a single Chinese public hospital.
Design/methodology/approach
Four surveys were administered to the staff of a single hospital, and a 100,000-word research diary was compiled from observation of the research process. A longitudinal case study design was administered from 2006 to 2009. The competing values tool was administered twice to assess organizational cultural change.
Findings
There was a change in the culture of different professional groups. The group with the strongest dominating culture type, which relies on cohesion, morale and employee participation in decision-making, shows the most positive change in cultural types during the BSC implementation process. Management innovations such as the BSC can create more balance in each professional group.
Practical implications
The successful implementation of a management innovation in a hospital requires the managers to consider meeting the demand of medical professional groups and achieve desired culture type change, which in turn may help to achieve the expected results.
Originality/value
This paper provides support to the finding that groups with a dominant group culture are more receptive to change and implementing a management innovation can influence professional group’s culture. It also provides evidence that the implementation of BSC can create more balance in each professional group’s culture. Although these findings come from health care, it may have relevance to other contexts in China.
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